GUIDELINES FOR DIAGNOSIS AND TREATMENT OF LOWER URINARY TRACT SYMPTOMS IN PATIENTS WITH MULTIPLE SCLEROSIS IN THE CZECH REPUBLIC– INTERDISCIPLINARY EXPERT CONSENSUS USING DELPHI METHODOLOGY

Česká verzia

Authors: Jan Krhut ^1,2; Olga Zapletalová ³; Roman Zachoval ^4,5,6; Eva Meluzínová ⁷; Libor Zámečník ⁸; Marta Vachová ⁹; Eva Houžvičková ⁷; Gabriel Varga ¹⁰
Authors place of work: Urologické oddělení, FN Ostrava ¹; Katedra chirurgických oborů, LF OU v Ostravě ²; Neurologická klinika LF OU a FN Ostrava ³; Urologické oddělení, Thomayerova nemocnice, Praha ⁴; Urologická klinika 1. LF UK Praha ⁵; Urologická klinika 3. LF UK Praha ⁶; Neurologická klinika 2. LF UK a FN Motol, Praha ⁷; Urologická klinika 1. LF UK a VFN v Praze ⁸; Neurologické oddělení, Nemocnice Teplice, o. z., Krajská zdravotní, a. s. ⁹; Urologická klinika LF MU a FN Brno ¹⁰
Published in the journal: Ces Urol 2017; 21(1): 20-28
Category: Review article

Summary

Aim:
Lower urinary tract symptoms are prevalent in approximately 75% of patients suffering from multiple sclerosis (MS) and have significant impact on their quality of life. There is a lack of evidence in many aspects of diagnostics and treatment of lower urinary tract symptoms in MS patients. The aim of the study was to provide guidelines for urologic diagnostics and treatment based on expert opinion in clinical practice in the Czech Republic.

Material and methods:
The guidelines were created using the DELPHI methodology. Comprehensive literature search according to PRISMA statement was performed. Based on this search, the first version of the guidelines was formulated. Members of a panel of experts rated individual items of the guidelines using a 9 point Lickert scale, where 1 means „strong disagreement“ and 9 means „strong agreement“. Subsequently, statistical analysis was performed. All items with rating median of less than 6 were updated. The second version of the guidelines was evaluated using the same technique.

Results:
In total, two rounds of communication were held. The second version of the guidelines was considered final due to high degree of consensus. Compared to the original version, 14 of 58 items were modified during the communication process. Average rating medians of the items included in the final version wa 8.22.

Conclusion:
Interdisciplinary consensus was reached using the DELPHI methodology. Resulting guidelines should be used by both urologist and neurologist in routine clinicalpractice.

KEY WORDS:
Multiple sclerosis, lower urinary tract symptoms, urinary incontinence, DELPHI.

Zdroje

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